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Module 5   Lesson 19   Wu Xing Bian Zheng

The Five Elements, and the field as a whole

How do you read a combination of organ patterns in the pentagon, and which of the ten models of module 5 do you use when?

After this lesson you can translate a combination of organs into generating, overacting or insulting, choose for a new complaint the model that answers the first question, and follow one illness as it moves from model to model. This is the closing lesson of module 5.

external disease internal disease routes Six Stages ch. 44 Cold penetrating inwards Four Levels ch. 45 hot disease, by depth Three Burners ch. 46 hot disease, by location Five Elements ch. 49 how organs affect each other Zang-Fu ch. 32 to 42 which organ Substances ch. 31 Qi, Blood, Body Fluids 12 channels ch. 47 along which pathway Extraordinary Vessels ch. 48 broad, deep, cyclical Pathogenic factors ch. 43: the bridge Wind, Cold, Summer-Heat, Dampness, Dryness, Fire; external and internal Eight Principles ch. 30: the grammar Exterior or Interior, Heat or Cold, Excess or Deficiency, Yin or Yang: every diagnosis ends here Part 5 ch. 27 to 29: the mechanism Excess and Deficiency, Yin-Yang disharmony, the Qi mechanism the arrows: lingering external disease turns internal; a lingering route reaches the organ
Our own arrangement of Part 6 (ch. 30 to 49) and Part 5 (ch. 27 to 29). The division into three columns is a teaching aid, not a division made by the book. Schematic.

Know by heart

  • Three relationships in ch. 49. Generating (mother and child), overacting, insulting.
  • Mother does not nourish child, round the edge. Liver-Blood to Heart-Blood; Heart to Spleen; Spleen-Qi to Lung-Qi; Lungs to Kidneys, which fail to receive Qi; Kidney-Yin to Liver-Yin and Liver-Yang (textbook knowledge). mnemonic: follow the edge: Wood, Fire, Earth, Metal, Water.
  • Four classics of the star. Wood overacts on Earth: Liver and Spleen (pattern 5). Wood insults Metal: Liver-Fire attacks the Lungs. Fire insults Water: Heart-Fire consumes Kidney-Yin (pattern 14). Water overacts on Fire: Water overflowing to the Heart (textbook knowledge).
  • Treatment rule. In deficiency tonify the mother, in excess sedate the child (Nan Jing 69). In overacting, restrain the controller and strengthen the controlled (textbook knowledge).
  • The field. Eight Principles first; substances, organs and Five Elements for internal disease; pathogenic factors as the bridge; Six Stages, Four Levels and Three Burners for external disease; channels and Extraordinary Vessels for routes.
  • Which model first. Acute with cold: Six Stages. Acute with fever and thirst: Four Levels and Three Burners. Pain on a pathway: channels. Cycle or constitution: Extraordinary Vessels. Chronic internal: Zang-Fu, with the pentagon for the connections. mnemonic: cold, hot, route, rhythm, rest.
  • Red flag. A model is not triage: high fever with confusion, sudden loss of function, unexplained weight loss, blood where it does not belong: see a doctor first, whatever model you are thinking in.

The rest of this lesson is reference.

According to the Five Elements; the field as a whole: How do you read a combination of organ patterns in the pentagon, and which of the ten models of module 5 do you use when?
The chart as an image, to save or share

Three practice questions from this lesson

Which three relationships does ch. 49 use?
  1. Generating, overacting, insulting
  2. Upper, Middle and Lower Burner
  3. Tai Yang, Yang Ming, Shao Yang

Answer: Generating, overacting, insulting. The book names patterns along the generating, overacting and insulting sequences. Tai Yang, Yang Ming and Shao Yang are stages of the Six Stages; the Burners belong to the Three Burner model.

Kidney-Yin deficiency leads to Liver-Yang rising.
  1. Water does not nourish Wood
  2. Wood insults Metal
  3. Earth does not nourish Metal

Answer: Water does not nourish Wood. Water is the mother of Wood; a deficient mother does not nourish the child.

Cough, red face and hypochondriac pain with outbursts of anger.
  1. Metal overacts on Wood
  2. Earth does not nourish Metal
  3. Wood insults Metal

Answer: Wood insults Metal. Metal normally controls Wood; Liver-Fire attacking the Lungs is the reverse direction.

The rest of this lesson

In the course you get the step-by-step explanation, 16 case-based practice questions, 20 spaced-repetition flashcards, the pitfalls and the bridge to physiology with evidence grades. This lesson belongs to module 5: Patterns.

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